Direct measurement of hepatic blood flow during living donor liver transplantation in children

Omori, Satoshi; Ishizaki, Yoichi; Sugo, Hiroyuki; Yoshimoto, Jiro; Imamura, Hiroshi; Yamataka, Atsuyuki; Kawasaki, Seiji

doi:10.1016/j.jpedsurg.2009.06.015

« Previous Next »Journal of Pediatric Surgery
Volume 45, Issue 3 , Pages 545-548, March 2010

Direct measurement of hepatic blood flow during living donor liver transplantation in children

Satoshi Omori
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Yoichi Ishizaki
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
- Corresponding author. Tel.: +81 3 3813 3111; fax: +81 3 3818 7589.
Hiroyuki Sugo
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Jiro Yoshimoto
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Hiroshi Imamura
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Atsuyuki Yamataka
- Department of Pediatric General and Urogenital Surgery, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Seiji Kawasaki
- Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan

Received 10 March 2009; received in revised form 9 June 2009; accepted 10 June 2009.

Abstract

Background

The changes in liver blood flow associated with living donor liver transplantation (LDLT) in children have not yet been studied. The aim of the present study was to investigate changes in hepatic hemodynamics before and after pediatric partial liver transplantation.

Methods

In 7 pediatric recipients with congenital cholestasis and native liver Child-Pugh classes B and C, portal vein flow (PVF) and hepatic arterial flow (HAF) were measured using an ultrasonic transit time flow meter before removal of the native liver and after transplantation and compared with donor left PVF and donor left HAF.

Results

The mean portal contribution to total hepatic blood flow was markedly decreased in the recipient native liver compared with that in the donor (69% ± 15% vs 32% ± 15%; P = .0003) and after reperfusion changed to almost the same ratio as that in the donor liver (73% ± 18%; P < .0001).

Conclusion

The extreme imbalance between PVF and HAF that is common in implanted partial liver in adult LDLT recipients was not observed in pediatric LDLT. After transplantation of an appropriately sized liver graft, the portal contribution to total liver blood flow normalized to the value for normal liver.

Key words: Pediatric liver transplantation, Living donor liver transplantation, Hepatic blood flow, Portal contribution